中西医结合治疗胫腓骨远端开放性骨折急性感染28例

28 Cases of Open Fracture of Distal Tibiofibular Bone with Acute InfectionTreated by Integrated Chinese and Western Medicine

目的:观察采取中西医结合方案治疗胫腓骨远端开放性骨折急性感染的临床治疗效果。方法:检索我科近7年来收治的GustiloⅡ型、Ⅲ型胫腓骨远端开放性骨折患者共148例,其中发生急性感染的患者有28例,回顾分析其治疗方案,我们采取中西医结合的方式,根据不同的病情采取不同的治疗方案,在清创、应用抗生素、引流、固定骨折等治疗措施的同时辨证使用中药汤剂内服。结果:28例患者中25例在急性期感染得到控制并治愈,3例形成慢性感染,经多次清创及对症治疗后感染治愈。感染治愈时间:28例患者中最短者14天,最长者98天,平均25.3±5.17天。术后功能康复采取AOFAS评分系统评价,28例患者中优11例,良9例,可3例,差5例。结论:中西医结合治疗开放性胫骨远端骨折急性感染取得良好的疗效,中医药应用于开放性损伤后急性软组织及骨感染的治疗具有提高机体抵抗力、控制感染、促进愈合的作用。

Objective: To observe the clinical effect of treating early infection of open fracture of lower tibiofibular bone and distal end with integrated Chinese and western medicine. Methods: A retrospective analysis of 28 patients with acute gustiloⅡand Ⅲ type of open fractures of the distal tibia and fibula treated in our department over the past 7 years. We adopted a combination of traditional Chinese and western medicine and different treatments according to different conditions. We used traditional Chinese medicine decoction for debridement, antibiotics, drainage and fixation of fractures. Results: Of the 28 patients, 25 were treated with acute infection, 3 cases of chronic infection. After multiple debridement and symptomatic treatment, the infection was cured. Treatment time :14 days for the shortest of 28 patients, up to 98 days, an average of 25.3±5.17 days. A AOFAS scoring system was used for postoperative functional rehabilitation, of the 28 patients, 11 were excerllent, 9 were good, 3 were well, 5 were bad. Conclusion: The combination of traditional Chinese and western medicine can improve the body resistance, control infection and promote healing.